MRD Negativity Improves With D-VRd in Newly Diagnosed Multiple Myeloma Patients
Recent findings from the PERSEUS study have shown that newly diagnosed multiple myeloma patients can benefit from a treatment approach that includes daratumumab, bortezomib, lenalidomide, and dexamethasone (D-VRd) both before and after autologous stem cell transplant.
Improved MRD Negativity Rates
The phase 3 PERSEUS trial revealed that patients who underwent D-VRd induction followed by DR maintenance had higher rates of sustained minimal residual disease (MRD) negativity compared to those who received standard induction with VRd, ASCT, and VRd consolidation. Data presented at the 2024 SOHO Annual Meeting demonstrated that MRD negativity rates were significantly higher in the D-VRd arm.
Sustained MRD Negativity
In the D-VRd arm, 64.8% of patients maintained MRD negativity at the 10-5 threshold for at least 12 months, whereas only 29.7% of patients in the VRd arm achieved the same result. Similarly, at a 10-6 sensitivity, the rates of sustained MRD negativity were also notably higher in the D-VRd arm.
Benefit for High-Risk Patients
Patients with high-risk disease also saw improved MRD-negativity rates with D-VRd compared to VRd, indicating a potential benefit for this subpopulation. The data suggests that D-VRd could be particularly advantageous in achieving and sustaining MRD negativity in high-risk multiple myeloma patients.
Long-Term Outcomes
Reaching MRD negativity, especially at a 10-6 sensitivity, was associated with improved long-term outcomes in both treatment arms. The findings support the use of D-VRd as a front-line therapy to increase the likelihood of achieving sustained MRD negativity, improved progression-free survival, and potentially enhanced overall survival.
Conclusion
In conclusion, the PERSEUS study underscores the importance of D-VRd and DR maintenance as a new standard of care for transplant-eligible newly diagnosed multiple myeloma patients. These data highlight the significance of achieving and maintaining MRD negativity in improving patient outcomes and suggest a potential shift in treatment approach for this patient population.
For more information, you can read about the FDA approval of D-VRd for induction and consolidation in patients with newly diagnosed multiple myeloma.
